Early experience with infectious complications of percutaneous femoral artery closure devices

Abstract

Percutaneous femoral artery closure devices are being used routinely after cardiac catheterizations. The use of these devices has been advocated to decrease length of stay, promote early ambulation, and prevent bleeding. We reviewed the use of these devices in our institution and report three cases of infectious complications (two pseudoaneurysms and one infected hematoma). Reports of infected pseudoaneurysms after cardiac catheterization before the implementation of these devices are rare. The use of these devices may be associated with an increased incidence of infected femoral pseudo-aneurysms.

Groin Infection Caused by a Percutaneous Femoral Artery Closure Device: Report of a Case

“…9 However, while the incidence of bleeding complications is decreased, some infectious complications associated with these devices have been reported. [2][3][4][5] In contrast, only 20 cases of infectious endarteritis have been reported after femoral artery catheterization with manual compression. 1 The precise incidence of infectious complications after percutaneous closure devices is unknown, but in two series, septic complications occurred in 0.3% and 1.5% of patients, respectively.…”

“…1 On the other hand, a significant number of cases of femoral artery infection after using percutaneous arterial closure devices have been reported. [2][3][4][5] In most of these patients, patch angioplasty or arterial bypass with a saphenous vein graft was required due to necrosis of the anterior wall of the common femoral artery. We report herein a case of femoral artery infection that developed after using a percutaneous arterial closure device, known as "The Closer" (Perclose, Redwood, CA, USA) for hemostasis.…”

A Case of Femoral Endarteritis Related to Using a Percutaneous Closure Device after Coronary Angiography

“…[4][5][6][7][8] The Perclose ® is a device that places a nonabsorbable braided polyester suture on both sides of a femoral artery defect after removal of the femoral catheter. The arteriotomy is then closed by tying the suture.…”

“…[1][2] However, several cases of serious vascular complications that required surgery have surfaced with using these devices. [3][4][5][6][7] We have experienced such a case and we present the first case of femoral artery infection in Korea after coronary angiography with the arterial access controlled with using the Perclose ® percutaneous closure device.…”

Infected Aortic Aneurysms

“…Vascular infections with infected aneurysm formation generally have four types of etiologies according to Wilson's classification [4,6]: (1) aneurysm formation after microbial arteritis due to bacteremia or local infection invasion, (2) posttraumatic infected pseudoaneurysms, which were usually related to drug abuse in the past and with increased incidence with the use of endovascular procedures [24] (3) infection of preexisting aneurysms, and (4) infected (mycotic) aneurysm resulting from infective endocarditis-related septic emboli (as described by Sir Osler) [1]. The intima of the arterial structure is normally resistant to infection; however, the presence of injury or pathological change makes it vulnerable to microorganisms, especially Staphylococcus and Salmonella species [25,26].…”